CHIKUNGUNYA OUTBREAK IN THE CARIBBEAN 2013-2014.

BACKGROUND: In December 2013, the local transmission of the mosquito-borne chikungunya virus was confirmed for the first time in several Caribbean islands. OBJECTIVE: To outline what is known to date on the outbreak of chikungunya in the Caribbean, and identify what is being done to detect and limit this infection. RESULTS: PAHO/WHO has recommended that chikungunya surveillance be set up in countries where there is existing dengue surveillance. Prospective travellers should be advised to take personal protective measures to avoid mosquito bites to decrease risk of exposure. Patients typically present with fever and arthralgia. If there is a positive travel history, serology for both chikungunya and dengue virus infection should be considered after consultation with local public health officials. Treatment is supportive. Transmission in Canada is not expected. CONCLUSION: Clinicians and public health professionals in Canada should be on the alert for sporadic cases of chikungunya virus in patients who present with fever and arthralgias after a stay in an affected Caribbean island.

Summary of the Public Health Agency of Canada's Action Plan on Lyme Disease.

BACKGROUND: Lyme disease is an emerging infectious disease in Canada that requires a comprehensive approach to prevention and control. It is a serious illness caused by a bacterium transmitted by certain types of ticks. The risk of Lyme disease currently exists in southern parts of British Columbia and Manitoba, southern and eastern Ontario, southern Quebec and New Brunswick, and in some locations in Nova Scotia. OBJECTIVE: To highlight the Public Health Agency of Canada's Action Plan on Lyme Disease, which aims to mitigate the risks to Canadians posed by Lyme disease through concrete activities being undertaken jointly with the provinces, territories, and various stakeholders. APPROACH: A multidisciplinary approach was used to assess the evidence on Lyme disease in Canada, analyze stakeholder concerns and evaluate what was currently available to inform public health professionals and the public. This assessment informed the development of an action plan intended to address the prevention, diagnosis and treatment of Lyme disease. RESULTS: The Action Plan on Lyme Disease sets out concrete action to be undertaken over three years, beginning in March 2014. It is built upon three pillars: 1.) Engagement, education and awareness, 2.) Surveillance, prevention and control, and 3.) Research and diagnosis. CONCLUSION: Effective prevention and control of Lyme disease in Canada requires a coordinated multi-partner and stakeholder engagement approach.